Category: Blog

According to the United States Department of Agriculture (USDA), more than 33 million Americans, including five million children, are considered food insecure. The United States Department of Health and Human Services (HHS) defines food insecurity as a household-level economic and social condition of limited or uncertain access to adequate food. While food insecurity does not necessarily cause hunger, hunger is a possible outcome of food insecurity. Adults who are food insecure may be at an increased risk for a variety of negative health outcomes and health disparities. For example, a study found that food-insecure adults may be at an increased risk for obesity. Another study found higher rates of chronic disease in low-income, food-insecure adults between the ages of 18 and 65. Food-insecure children may also be at an increased risk for a variety of negative health outcomes, including obesity. They also face a higher risk of developmental problems compared with food-secure children. In addition, reduced frequency, quality, variety, and quantity of consumed foods may have a negative effect on children’s mental health.

In an effort to address this issue, President Joe Biden hosted the White House Conference on Hunger, Nutrition, and Health and announced over $8 billion in hunger and nutrition commitments. It was only the second-ever conference of its kind and the first in over fifty years. The last time this conference took place was in 1969, under President Richard Nixon. The Nixon-era conference was a pivotal moment that led to the creation of the big programs underpinning the United States hunger response, such as food stamps and the Women, Infant, and Children program (WIC), which provides child nutrition assistance among other things. The Biden administration used this as an opportunity to lay out its plan to improve the nation’s health. This plan includes pushing for Congress to permanently extend the child tax credit, raise the minimum wage, and expand nutrition assistance programs to help reduce hunger rates. This ties to an ambitious goal the president set in May—ending hunger in the United States by 2030.

The $8 billion in commitments comes from some of the largest corporations in America’s private sector—Google, Tyson Foods, Walgreens—and includes $4 billion that will be dedicated by philanthropies that are focused on expanding access to healthy food. Additionally, there will be a focus on expanding nutrition research and encouraging the food industry to lower sodium and sugar. However, some of the most ambitious proposals require Congressional action. Thus, the partisan split threatens the president’s success.

Furthermore, the conference comes at a time of steep inflation and the end of pandemic benefits that staved off hunger rates. While the expanded child tax credit that was part of the American Rescue Plan of 2021succeeded in reducing poverty and hunger in the United States, Democrats were unable to make that measure permanent in the Inflation Reduction Act that they passed this year. Now, lines at food banks keep getting longer, food prices are rising at their fastest rate in four decades and fears of a recession that could result in higher unemployment rates are growing.

Unfortunately, while the Biden-Harris administration’s strategy includes many great ideas, it also seems to let the food industry off the hook and fails to adequately address the impact that racism, gender inequality, and the climate crisis on food insecurity. Though the conference served as a good first step toward future investments and policy changes around combatting food insecurity, there is still a long road ahead and the administration must do more to achieve its goal of ending hunger by 2030.

On September 30, 2022, the Food and Drug Administration (“FDA”) issued a food safety alert after two kinds of cheese were linked to a listeria outbreak. The cheeses in question? Brie, baked brie, and camembert cheeses made by Old Europe Cheese, Inc. The products were sold under 25 different brand names in major retail stores such as Safeway, Whole Foods, and Trader Joe’s both nationwide and in Mexico. 

The recalled products consist of a wide variety of cheeses, ranging from double crème wedges to cranberry baked brie. However, it is far from the first grocery recall that has happened this year. A study conducted by Agruss Law Firm found that in 2022 alone, salmonella and listeria outbreaks led to 49 food and beverage recalls from the FDA, representing 37.4% of all food product recalls. It is a considerable increase compared to 33.3% in 2021 and consists of more than 45% of recalls this past year. 

In addition, more than a fifth of grocery recalls this year came from peanut butter products contaminated with salmonella. On May 20, the FDA released a statement announcing the voluntary recall of nearly 50 Jif products for potential salmonella contamination. The recall also affected products distributed in international markets including countries such as Canada, Thailand, and Honduras. An epidemiological review conducted by the Center for Disease Control and Prevention (“CDC”) examined a multistate outbreak of salmonella senftenberg infections. In a joint investigation between the FDA and CDC, the CDC found that out of ten people interviewed, all ten consumed peanut butter and nine out of ten people ate Jif peanut butter products before they became sick. In total, 21 people from 17 states fell ill and four people were hospitalized. Using a process known as Whole Genome Sequencing (WGS) analysis, the FDA discovered that the outbreak was linked to Jif products produced at the J.M. Smucker Company facility in Lexington, Kentucky. Jif then issued a report describing a machinery breach that allowed puddles of water to come into contact with peanut roasting equipment. Plant officials also discovered past incidents of salmonella found at the facility and a report obtained by Axios indicated that the issue may have been considered a routine error or ignored by the company altogether. 

However, food recalls this year weren’t limited to cheese and peanut butter. The number of recalled products during the first quarter of 2022 was also the highest figure in a decade due to a large recall of baby formula. This past February, the FDA published a company announcement concerning a voluntary recall of powder formulas produced in a plant owned by Abbott Nutrition. In total, the announcement stated that four infants from three different states contracted a cronobacter sakazakii infection after consuming powdered formula, resulting in two deaths. The FDA’s inspection of the plant revealed that key production areas, including the machinery and floor of the packaging room, tested positive for cronobacter. And similar to the Jif plant, FDA inspectors discovered a water leak dripping from the valves, leading to standing water on the floor and near the floor scrubber. The FDA also found that the company failed to identify the root causes of the cronobacter complaints and that employees in contact with the infant formula did not sanitize their shoes or wear proper protective gear while working. 

Many of the issues stemming from recent food recalls can be traced back to supply chain issues and a lack of corporate oversight. While the passage of the Food Safety Modernization Act (FSMA) in 2011 gave the FDA greater authority in responding to food safety complaints, the regulations remain at odds with the increased industrialization and expansion of facilities. However, an increase in food recalls does not necessarily mean an increase in food-borne illnesses or contamination. Since the FSMA allows companies to recall products as a precaution, it enables the FDA to prevent health threats before they begin. As a result, it is important to keep in mind how these recalls can affect consumers of all ages and socioeconomic backgrounds, and to consider how the legal system can provide remedies to resolve issues in safety regulations and corporate oversight.

The Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which eliminated the federal right to abortion has produced more questions than answers. It not only created uncertainty around the future of abortion accessibility and legality, but also around birth control and contraceptives. As states begin to test the new limits of what overturning Roe v. Wade truly means – a difficult question presents itself: Will states extend abortion restrictions to limit certain types of contraceptives?

One type of contraception stands out as particularly at-risk: Intrauterine devices (“IUDs”). Laws based on the viewpoint that “life begins at fertilization” are particularly ripe for a broad and far-reaching interpretation that could eventually include banning this type of contraception.

The concept that a fetus is considered an unborn child is not new. However, the idea of fetal personhood has taken on new meaning and is helping drive exceptionally restrictive anti-abortion measures. These measures are likely to move beyond, or at least test the limits of, what is traditionally considered abortion.

IUDs are generally known as a preventative form of birth control, blocking fertilization and sometimes ovulation. However, they can also prevent implantation of a fertilized egg; this is the scenario in which IUDs enter a gray area in states that define life as beginning at fertilization.

In Kentucky, which has one of the most restrictive abortion bans in the country, the statute currently provides an exemption for contraceptives. However, it’s easy to see how a strict interpretation of the statute’s key definitions could result in the exclusion of contraceptives in the future. For example, the Kentucky statute defines an “unborn human being” as beginning at fertilization, yet it concludes by stating that “nothing in this section may be construed to prohibit…a contraceptive measure.” The language of the statute contradicts itself: It clearly exempts contraceptives from the ban, but key terms have been defined in a way that suggests they should not be exempt.

Meanwhile, in statutes that do not state an exemption for contraceptives that inhibit fertilization, IUDs are an open question. The legality of these contraceptives will likely be determined by the courts, or through clarifying language in amended statutes. Legislators in Missouri, Idaho, and Louisiana, among others, have already declared that life begins at fertilization. Missouri’s statute is one of the most restrictive; there are no exceptions for rape or incest. Confusion about the terms of Missouri’s statute were almost immediate. A hospital system in Kansas City stopped providing emergency contraception as soon as the state’s trigger ban took effect, and only resumed providing it upon clarification from the governor that contraceptives were exempt from the ban.

The lack of clarity and consistency in terminology poses a barrage of questions for pregnant individuals, families, doctors, and insurance providers. Legislatures will either have to continue refining and updating statutes as confusion arises, or the courts will become the interpreters, inserting precision into vague and potentially conflicting statutory language.

Legislators could argue that their intention is to only ban abortion procedures, as evidenced by the current carve-outs for contraceptives. However, in light of the other types of exemptions up for debate, the underlying intent warrants skepticism. Other exemptions in question include whether to allow abortion procedures in cases of rape, incest, and non-viable pregnancies, which suggests that the objective is to impose increasingly stringent restrictions. As these questions arise state-by-state, in legislatures that are constantly prescribing more restrictive measures, it is hard to imagine that definitive clarifications are coming anytime soon. 

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The right to choose to have an abortion has been recognized as a constitutional right in the United States for nearly fifty years since Roe v. Wade. However, states have the right to impose restrictions on abortions until the vague point of “viability,” as long as the restriction does not present an undue burden to those seeking an abortion. For as long as the right to choose has been established, many states have persisted in efforts to chip away at abortion access by imposing a variety of restrictions. Since Roe, more than 1,000 restrictive laws have been enacted across the United States to limit abortion access. These efforts are gaining momentum, and more than a quarter of abortion-restrictive laws were enacted between 2010 and 2015. The trend has continued, and 2021 was the most restrictive year on abortion in American history. 

Abortion access has a long history of being weaponized as a political tool in the United States, and with increasing political pressures, more abortion restrictions than ever, and a conservative majority in the Supreme Court, this trend continues today. At the center of the current fight is Dobbs v. Jackson Women’s Health Organization, a case that was argued before the Supreme Court in December 2021. The case is regarding a Mississippi ban on abortions prior to 15 weeks of pregnancy, and will be the first case since Roe in which the court will determine the constitutionality of pre-viability abortion restrictions. The ruling, which is anticipated by the end of the Court’s term in June 2022, has the dangerous potential to overturn Roe and establish that there is no constitutional right to abortion in the United States. 

The consequences of the Dobbs ruling will be severe, whether Roe is overturned entirely, or if states are permitted to expand restrictions to abortion access. Approximately half of states are considered likely to completely outlaw abortion, or limit access to the point that abortions would be virtually inaccessible, following the ruling in Dobbs. Only fourteen states and the District of Columbia protect the right to abortion in their state laws or constitutions, and just five states protect both the right to abortion and have policies in place to enhance access to abortion. The stark contrast between states that will ban abortion and the few that will protect the right will create barriers to access in the nation where approximately 1 in 4 *women will have an abortion by age 45. It is important to acknowledge that lack of access to abortion has a disproportionate impact on low-income individuals and People of Color.  

In recognition of the importance of abortion access and the increasing threats to the right to choose, recent attempts to protect abortion at the federal level have made it farther than ever before. The Women’s Health Protection Act of 2021 would have enshrined the right to abortion in national law; however, after it passed in the House it failed to pass a Senate vote in March 2022. While this outcome is disappointing at a time when abortion rights are more at risk than ever, it is encouraging that the majority of American voters supported the WHPA, and marks important progress as the first time the Senate voted on legislation for the federal right to abortion. 

The right to abortion in the United States faces some of its most challenging obstacles to date. While the depth of the hill we continue to climb is to be determined by the outcome of Dobbs, regardless we must persist until abortion access for all is realized. 

*This post refers to “women” when the data being referenced refers specifically to women. It is important to acknowledge that abortion access impacts all people who may become pregnant, including trans and non-binary individuals. 

It is an unfortunate enough reality that the world is concerned about the threat of naturally occurring biological hazards, but now there is a real fear that terrible biological weapons may make a reappearance. While many may consider the Covid-19 pandemic to be a “once in a lifetime” tragedy, there is reasonable concern that a lack of preparedness may give rise to another pandemic sooner than we may think. Although, we may not have time to focus on preventing another naturally occurring biological disaster because there is a serious concern that Russia may employ biological weapons in their invasion of Ukraine.

A biological weapon specifically involves using a living organism to inflict harm on others. The classic example would be depictions of Roman or Mongol armies throwing dead animals in an enemy’s water supply to ensure that disease would spread through the ranks. Since the Classical age, humans have only grown uncomfortably more efficient in all aspects of warfare and biological weapons have undergone terrifying advancement. Since 2008, more than 20 countrieshave maintained a biological weapons department and the former Soviet Union extensively researched the subject.

In October of 2021, NATO acknowledged the possibility of another devastating pandemic then began to ring the alarm bells that certain countries have the capability and motive to unleash devastating biological weapons that many would be unprepared to counter. Barely a month later, and likely in response to the then escalating tension between Russia and Ukraine, the Biden administration formally voiced their concern about the proliferation and potential use of biological weapons. The administration agreed with NATO that there needs to be a united global stance against the development of biological weapons and thorough cooperative strategies to prevent the threat of another pandemic. Thankfully, there are indications that Congress is willing to support President Biden in this area.

Republican Senator, James Risch, introduced bill 2912 last year that directly addresses the devastation of the Covid-19 pandemic and the actions the United States must take to prevent another natural, or weaponized, biological disaster. The bill calls on the government to make assessments of foreign countries, specifically Russia and China, and potentially ban all cooperative research funding if those countries are found to not be compliant with the Biological Weapons Convention. Additionally, the bill would call upon the United States to actively use its leverage within the United Nations to condemn the offending countries and prevent them from seeking any position of power within the sphere of global health.

The threat of these weapons cannot be understated. Even Russia is spreading obvious misinformation that their justification for invading Ukraine was because of alleged bio-labs within the now besieged nation. As the conflict in Ukraine continues, the likelihood of Russia resorting to utilizing biological weapons among its many other war crimesonly increases. Congress has shown initiative in recognizing that the United States needs to be proactive in its defense against biological hazards, so there is hope that the often-divided institution will come together to condemn any use of such a weapon and react accordingly. 

Over the past twenty-five years, the United States has experienced an increasingly devastating opioid crisis.  According to the Department of Health and Human Services (HHS), in the late 1990s, pharmaceutical companies offered reassurance to the medical community that patients would not become addicted to opioid pain relievers, leading healthcare providers to begin prescribing them at greater rates.  Increased prescription of opioid medications led to widespread misuse of both prescription and non-prescription opioids before it became clear that these medications could indeed be highly addictive.  

The Centers for Disease Control and Prevention (CDC) outlines the rise in opioid overdose deaths in three distinct waves.  The first wave began with increased prescribing of opioids in the 1990s, with overdose deaths involving prescription opioids increasing since at least 1999.  The second wave began in 2010, with rapid increases in overdose deaths involving heroin.  The third wave began in 2013, with significant increases in overdose deaths involving synthetic opioids, particularly those involving illicitly manufactured fentanyl.  The market for illicitly manufactured fentanyl continues to change, and it can be found in combination with heroin, counterfeit pills, and cocaine.  In 2017, HHS declared a public health emergency to address the national opioid crisis and announced a five-point strategy with the following priorities: improve access to prevention, treatment, and recovery support services; target the availability and distribution of overdose-reversing drugs; strengthen public health data reporting and collection; support cutting-edge research on addiction and pain; advance the practice of pain management. 

The COVID-19 pandemic has created a devastating public health crisis and has posed significant challenges for health care delivery, including opioid use disorder (OUD) treatment.  Like the opioid crisis, the COVID-19 pandemic has had a disproportionate impact on racial and ethnic minority groups, particularly those who use drugs.  For example, one recent study showed that Black people with OUD are not only at significantly increased risk for COVID-19, but also have greater odds of hospitalization and mortality.  This reflects how Black communities have been subjected to the dual burden of disproportionate COVID-19 deaths and rising overdose mortality.

Methadone has been successfully used for over forty years to treat OUD and must be dispensed through specialized opioid treatment programs.  To receive the treatment, individuals have to show up every day for ninety days to receive their dose.  Only after that, are they able to take home a weekly bottle.  To get a full month’s worth of take-home methadone, individuals need to have been going to the clinic for two years.

Buprenorphine reduces cravings without becoming addictive itself and has been found to have similar effectiveness as methadone for treating OUD when given at a sufficient dose and for sufficient duration.  However, unlike methadone, buprenorphine can be prescribed by certified health care providers.  This eliminates the need to visit specialized treatment clinics, thus expanding access and providing an option for individuals with OUD who are unwilling or unable to attend a licensed methadone treatment program.

While both methadone and buprenorphine have been shown to reduce opioid misuse compared to abstinence-only interventions, buprenorphine has the greatest potential for widespread dissemination due to its relative ease of use and safety.  However, findings from several studies suggest buprenorphine and methadone treatment rates are correlated with race and ethnicity.

The following recommendations have been proposed by public health professionals and, if adopted, could help address the racial disparities in access to medications for OUD.  First, the requirement that a health care provider must complete a course before they are able to prescribe buprenorphine should be lifted. Second, newly diagnosed OUD patients should be offered both buprenorphine and methadone as treatment options.  Furthermore, patients currently receiving methadone should be offered the option to transition to buprenorphine.  Third, policies and regulations should be changed to allow pharmacy-led methadone dispensing.  Steps such as these must be taken to ensure all Americans, regardless of race or ethnicity, have equal access to health care.  Otherwise, this would be a missed opportunity to improve public health.